Oral Cancer Guideline (2026 Update)

These updated recommendations explore the use of four different adjuncts in early oral cancer detection. The multi-part series exploring cancer detection methods assess cytology, vital staining, light-based and salivary adjuncts.

Early detection of oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) can improve patient outcomes. Although biopsy remains the diagnostic standard, this multi-part series developed in collaboration with the Center for Integrative Global Oral Health at the University of Pennsylvania School of Dental Medicine (Penn Dental Medicine) provides updated recommendations on the appropriate use of cytology, vital staining, light-based and salivary adjuncts.

For questions or comments about the living guideline, please contact guidelineprogram@ada.org.

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To view full guidelines in JADA Evidence:

Cytology
Collection of a cell sample from an oral mucosal abnormality with a brush.
Article
Article
Vital staining
Use of a stain to detect increased relative DNA content on abnormal mucosal lesions.
Article
Article
Light-based
Use of a specialized light to detect abnormalities that are not visible under white light. 
Article
Article
Salivary
Use of salivary samples to detect biomarkers for the early detection of OPMDs and OSCC.
Article
Article
How should clinicians implement these recommendations into practice?

The interactive living guideline is designed to be implemented directly in clinical practice. It functions as a chairside decision support tool, allowing clinicians to quickly review current recommendations, supporting evidence, and patient-centered considerations in real time. Because the guideline is continually updated, clinicians can be confident they are applying the most current evidence into practice.

Clinician resources
Patient resources
ARCHIVE: 2017 Guideline: Evaluation of Potentially Malignant Disorders in the Oral Cavity Clinical Practice Guideline

A panel of experts convened by the ADA Council on Scientific Affairs presents a clinical practice guideline to inform clinicians about the potential use of adjuncts as triage tools for the evaluation of lesions, including potentially malignant disorders (PMDs), in the oral cavity.

Key Points

  • Clinicians should obtain an updated medical, social, and dental history and perform an intraoral and extraoral conventional visual and tactile examination in all adult patients.
  • For patients with suspicious lesions, clinicians should immediately perform a biopsy of the lesion or refer the patient to a specialist.
  • Salivary and light-based adjuncts are not recommended for evaluating lesions for malignancy.

Clinician resources